title: Work productivity in a population-based cohort of patients with spondyloarthritis.
abstract: OBJECTIVE
  To assess work productivity and associated factors in patients with SpA.
  
  
  METHODS
  This cross-sectional postal survey included 1773 patients with SpA identified in a regional health care register. Items on presenteeism (reduced productivity at work, 0-100%, 0 = no reduction) were answered by 1447 individuals. Absenteeism was defined as register-based sick leave using data from a national register. Disease duration, disease activity (BASDAI), physical function (BASFI), health-related quality of life (EQ-5D), anxiety (HAD-a), depression (HAD-d), self-efficacy [Arthritis Self-efficacy Scale (ASES) pain and symptom], physical activity and education were also measured.
  
  
  RESULTS
  Forty-five per cent reported reduced productivity at work with a mean reduction of 20% (95% CI 18, 21) and women reported a higher mean reduction than men (mean 23% vs 17%, P < 0.001). Worse quality of life, disease activity, physical function and anxiety all correlated with reduced productivity (r = 0.52-0.66, P < 0.001), while sick leave did not. Worse outcomes on the EQ-5D (β-est -9.6, P < 0.001), BASDAI (β-est 7.8, P < 0.001), BASFI (β-est 7.3, P < 0.001), ASES pain (β-est -0.5, P < 0.001) and HAD-d (β-est 3.4, P < 0.001) were associated with reduced productivity at work in patients with SpA regardless of age, gender and disease subgroup. ASES symptoms, HAD-a and education level <12 years were associated with reduced productivity but were not significant in all strata for age, gender and disease subgroup.
  
  
  CONCLUSIONS
  Work productivity was reduced in patients with SpA and more so in women. Worse quality of life, disease activity, physical function, self-efficacy and depression were all associated with reduced productivity at work in patients with SpA.
authors.affiliation: Research and Development Center, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden. emma.haglund@spenshult.se
authors.forename: Emma
authors.initials: E
authors.lastname: Haglund
authors.forename: Ann
authors.initials: A
authors.lastname: Bremander
authors.forename: Stefan
authors.initials: S
authors.lastname: Bergman
authors.forename: Lennart T H
authors.initials: LT
authors.lastname: Jacobsson
authors.forename: Ingemar F
authors.initials: IF
authors.lastname: Petersson
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004526:Efficiency; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D020377:Self Efficacy; D012720:Severity of Illness Index; D018582:Sick Leave; D025241:Spondylarthritis / Q000523:psychology*; D017132:Workplace
keywords: absenteeism; patient-reported outcomes; presenteeism; spondyloarthritis; work productivity